Read about bone marrow tests, what they are and what happens when you have one.
You have this test to check whether there are cancer cells in your bone marrow. Bone marrow is spongy tissue and fluid that is inside your bones. It makes your blood cells.
A doctor or specialist nurse removes a sample of bone marrow cells or an area of bone marrow in one piece. This is usually from your hip. Doctors can then look at the cells or tissue under a microscope.
You have the test in the outpatient department of the hospital.
You have a local anaesthetic to numb the area. This means you are awake, but the test shouldn't be painful.
Why you might have a bone marrow test
Bone marrow tests are usually done for cancers that are most likely to affect the bone marrow, such as:
But it can be done for any type of cancer if your doctor thinks your bone marrow could contain cancer cells, or needs to rule this out for any reason.
Types of biopsy
There are 2 main types of bone marrow test – a bone marrow aspiration and a bone marrow trephine biopsy.
Aspiration means the doctor or nurse sucks some bone marrow cells up into a syringe.
A bone marrow trephine means that they remove a 1 or 2cm core of bone marrow in one piece.
You usually have both of these tests done at the same time. They give some of the same information to the doctor, but there are differences. The bone marrow trephine shows the structure of the bone marrow inside the bone, whereas the aspiration takes just the bone marrow cells.
Your doctor will ask you to sign a consent form once they have given you information about the procedure. This is a good time to ask any questions you have.
You usually lie on your side with your knees tucked up into your chest. Your doctor or nurse cleans the area with some antiseptic fluid. This can feel cold.
You have a local anaesthetic injection into the skin over the biopsy site to numb it. When this has worked your doctor or nurse puts the needle in through the skin. It goes into the centre of the bone, where the marrow is.
Your doctor or nurse sucks a small amount of liquid bone marrow into the needle, using a syringe. You feel a pulling sensation when they start drawing the bone marrow cells out but some people have a sudden, sharp pain.
The doctor or nurse will take this needle out and put the second one in if you are having a trephine biopsy as well. The aim is to get a small amount of marrow out in one piece.
The needle going into the hip bone can be painful but this only lasts a short time. The whole test takes 15 to 20 minutes.
Your bone marrow is the spongy substance in the centre of the bones where the blood cells are made.
You may have a bone marrow test if you have a cancer which affects the bone marrow such as leukaemia, lymphoma or myeloma. Or if your doctor thinks your bone marrow may contain cancer cells that have spread from another type of cancer.
There are two types of tests. A bone marrow aspiration which takes some bone marrow cells and a bone marrow biopsy which takes samples of the bone marrow and gives more information about its structure.
Usually your doctor takes the sample from your hip bone but you can have a bone marrow aspiration from your breast bone.
You have the test lying on a couch. If you’re having a biopsy you may have a sedative beforehand to make you sleepy.
The doctor then injects some local anaesthetic to numb the area.
For a bone marrow aspiration they put a needle into your skin and put it into the centre of your bone. Then using a syringe they draw out some bone marrow cells. You may feel a pulling sensation as they do this.
For a biopsy the doctor uses a slightly bigger needle to take the sample. They turn and push this needle to get the sample. This can be painful as the needle goes in but it doesn’t last for long.
You can go home once any drowsy feeling from the medication has worn off.
Afterwards your hip will ache for a few days. Taking painkillers helps.
You may have some slight bleeding from the site. Press on it if you do and if it doesn’t stop contact the hospital.
You may have some tingling in your leg which will also wear off with time.
Some people prefer to have some type of sedative before the test so that they are a bit drowsy. Some hospitals may use gas and air (Entonox) to help relax you instead of sedation.
Children and teenagers often have sedation for this type of test.
After your bone marrow aspiration
If you have a sedative, you need to stay at the hospital for a few hours until it has worn off. And you need someone with you so that you don't have to go home on your own.
You can go home that day if you are feeling well enough.
You have a dressing over the site, which you should keep on for 24 hours. If you notice any bleeding apply pressure to the area. If it doesn't stop, contact the hospital.
After the test, your hip might ache for a couple of days. You may need some mild painkillers such as paracetamol to take at home.
Possible risks from bone marrow test
A bone marrow test is very safe and any risks are small.
During the procedure there is a very small risk of damage to nearby structures. The needles that doctors use have a guard on them now which stops the needle going too deep so it is unlikely to be a problem.
Some people have a small amount of bleeding from the site where the needle went in. If you are on medication to thin your blood, such as warfarin, you may need to stop taking these before the test. Your doctor will advise you when and how long to stop taking them.
You will have a dressing over the site which you should keep on for 24 hours. If you notice any bleeding apply pressure to the area. If it doesn't stop, contact the hospital.
There is a small risk of getting an infection in the wound. Tell your doctor if you have a temperature or the area becomes red and sore.
Getting your results
Waiting for test results can be a very worrying time. You can contact your specialist nurse if you are finding it hard to cope. You can also get in touch with them to ask for information if you need to. It can also help to talk to a close friend or relative about how you feel.
We have more information on tests, treatment and support if you have been diagnosed with cancer.